Provider Demographics
NPI:1699965673
Name:HOLY CROSS HOSPITAL ADULT DAY CARE
Entity type:Organization
Organization Name:HOLY CROSS HOSPITAL ADULT DAY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP & CFO
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:KEESE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-754-7201
Mailing Address - Street 1:1500 FOREST GLEN RD
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-1483
Mailing Address - Country:US
Mailing Address - Phone:301-754-7035
Mailing Address - Fax:
Practice Address - Street 1:9805 DAMERON DR
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20902-5717
Practice Address - Country:US
Practice Address - Phone:301-754-7150
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOLY CROSS HEALTH, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-07-26
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD16250311Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD000435900Medicaid